scholarly journals Diagnostic Value of Fetal Thymus Size in Intrauterine Growth Restriction

Author(s):  
Mohamed Mosaad Elshishiny ◽  
Mohamed Mohsen Elnamoury ◽  
Ayman Abd Elaziz Aldorf ◽  
Essmat Hamdy AboZeid

Background: Changes in thymus size and histopathology have been observed both in animal models of intrauterine growth restriction (IUGR). The aim of the present study was to evaluate the size of the fetal thymus by sonography in pregnancies with IUGR and to search for a possible relationship between a fetal thymus size and adverse perinatal outcomes. Methods: This prospective observational study was carried out on 100 participants who were divided into two groups. Group A: Study group which include 50 patients with IUGR. Group B: Control group which Include 50 normal patients with appropriate gestational age. All patients were subjected to: History taking: (Personal, Obstetric History, Maternal Medical History) and trans-abdominal ultrasound. Results: IUGR group show statistically significant decrease in the estimate of fetal weight (EFW) compared to the control group (P<0.05). Doppler study of umbilical artery shows significant increase of (pulsatility index (PI), resistance index (RI) and systolic/diastolic (S/D) in IUGR group when compared to control group. Doppler study of middle cerebral artery (MCA) shows significant increase in (RI, SD) in IUGR group when compared to control group while PI doesn’t show significant difference between two groups.  Thymus size decrease in IUGR group when compared to the control group. IUGR group had low survival and lower APGR Score when compared to the control group. Correlation between thymus size with the studied doppler parameters and pregnancy outcome in the current study. Umbilical Doppler RI, PI and SD showed statistically significance in this study (P<0.05) and this means that the blood flow in the umbilical arterial (UA) is important for the fetus. As regard the MCA RI and SD Doppler, they show statistically significance in this study (P<0.05) while the MCA PI Doppler did not show any statistically significance in this study (P>0.05). Conclusions: IUGR is associated with small thymus and small fetal thymus may be an early indicator of adverse perinatal outcomes in pregnancies complicated by IUGR.

2021 ◽  
pp. 875647932110547
Author(s):  
Elham Keshavarz ◽  
Marjan Rustazade Sheikhyusefi ◽  
Ensi Khalili Pouya ◽  
Masoumeh Mirzamoradi ◽  
Mehdi Khazaei ◽  
...  

Objective: The objective of this study was to evaluate the association between reduced fetal thymus size and intrauterine growth restriction (IUGR). This study was devised to determine the association between thymus size and any abnormal Doppler indices within the fetal umbilical artery (UA), as well as the middle cerebral artery (MCA). Materials and Methods: Forty-six pregnancies between 20 and 38 weeks of gestation with IUGR and 46 normal pregnancies within similar gestational age (GA) range were included. The transverse diameter of fetal thymus was measured. In the IUGR group, the fetal umbilical artery (UA) and middle cerebral artery (MCA) Doppler flow velocities were recorded. Results: The mean GA of fetuses with IUGR (33.5 weeks) was higher than control group (30.3 weeks). To adjust for the effect of GA, analysis of covariance (ANCOVA) was performed. The adjusted mean thymus diameters were 19.02 mm in IUGR and 21.25 within the control group (mean difference = 2.23 mm; P = .02). The mean (±SD) thymus size in 16 fetuses, with abnormal Doppler findings, was significantly lower than in the group with normal Doppler findings, 17.45 (±2.50) vs 22.02 (±5.39) mm; P < .001. Conclusion: IUGR may be associated with reduced fetal thymus size, especially when coupled with abnormal Doppler findings. The thymus size in a group of IUGR fetuses, with abnormal Doppler findings, was smaller than IUGR fetuses, with normal Doppler findings.


2007 ◽  
Vol 196 (5) ◽  
pp. e48-e51 ◽  
Author(s):  
Juan M. Gonzalez ◽  
David M. Stamilio ◽  
Serdar Ural ◽  
George A. Macones ◽  
Anthony O. Odibo

2019 ◽  
Vol 47 (8) ◽  
pp. 841-846 ◽  
Author(s):  
Murat Akbas ◽  
Faik M. Koyuncu ◽  
Burcu Artunç-Ulkumen

Abstract Background Placental elasticity varies in different diseases. Our objective was to evaluate placental elasticity using point shear wave elastography (pSWE) in pregnancies with intrauterine growth restriction (IUGR). Methods A total of 66 pregnant women with IUGR and 81 healthy pregnant women were enrolled. Placental elasticity was measured using the transabdominal pSWE method. Ten measurements were made, and the mean was accepted as the mean placental elasticity value in each case. The results for IUGR pregnancies and controls were compared. Results The mean pSWE values were significantly higher in pregnancies with IUGR, which means that women with IUGR have stiffer placentas (P < 0.001). Furthermore, the pSWE values were significantly and positively correlated with Doppler indices and adverse perinatal outcomes. Conclusion The pregnancies with IUGR had stiffer placentas than the healthy controls. The utilization of pSWE for placental elasticity may be useful in the diagnosis and management of IUGR as a supplement to the existing ultrasonography methods.


2015 ◽  
Vol 143 (11-12) ◽  
pp. 701-706 ◽  
Author(s):  
Monica Hăşmăşanu ◽  
Sorana Bolboacă ◽  
Tudor Drugan ◽  
Melinda Matyas ◽  
Gabriela Zaharie

Introduction. Linear growth failure is caused by multiple factors including parental factors. Objective. The aim of this study was to evaluate parental risk factors for intrauterine growth restriction (IUGR) on a population of Romanian newborn infants in a tertiary level maternity facility for a period of 2.5 years. Methods. A retrospective matched case-control study was conducted in the Emergency County Hospital of Cluj-Napoca, a university hospital in North-Western Romania. The sample was selected from 4,790 infants admitted to the Neonatal Ward at 1st Gynecology Clinic between January 2012 and June 2014. Results. The age of mothers was significantly lower in the IUGR group compared to controls (p=0.041). A significantly higher percentage of mothers had hypertension in the IUGR group compared to those in the control group (p<0.05). No other significant differences were identified with regard to the investigated characteristics of mothers between IUGR infants compared to controls (p>0.13). The age of fathers of infants with IUGR proved significantly lower compared to controls (p=0.0278). The analysis of infants? comorbidities revealed no significant difference between groups for respiratory distress, hyperbilirubinemia, hypocalcaemia, and heart failure (p>0.27). Intracranial hemorrhage, necrotizing enterocolitis and hypoglycemia were significantly higher in the IUGR group compared to controls. The logistic regression identified hypertension as a significant risk factor for IUGR (OR=2.4, 95% CI [1.3-4.5]). Conclusion. Although the age of the mothers and fathers proved significantly lower in the IUGR group compared to controls, only hypertension in the mothers proved significant risk factors for IUGR.


Author(s):  
Sara E. Khalil ◽  
Mohammed M. Elnamory ◽  
Mona K. omar ◽  
Hesham M. Eltokhy

Background: Preeclampsia (PE) is a disorder that causes hypertension and proteinuria after week 20 of pregnancy. Several Uterine Artery (UtAs) Doppler characteristics have been investigated for their ability to predict PE. The purpose of this research is to look into the uterine and umbilical arterial Doppler indices in the early second trimester for the prediction of late preeclampsia or intrauterine growth restriction. Methods: This is a prospective cohort clinical study and was done at Obstetrics and Gynecology department, faculty of medicine Tanta university hospital from January 2020 till April 2021. 150 pregnant women aged from 18 to 30 years old with gestational age from 13 to 16 weeks of pregnancy. Study was done by the same observer by machine MINDRAY DC60 Measurement of fetal biometry (BPD, FL, AC, HC) Gestational age was confirmed with Detection of congenital malformation.    Results: There is a significant difference between the groups regarding uterine and umbilical artery doppler Indices. Uterine RI only yielded significance for predicting IUGR with sensitivity of 62% and specificity of 88%, with Positive predictive value (PPV) 37% and Negative predictive value (NPV) 92%. Umbilical resistance index achieved sensitivity of 56% and specificity of 82%, with PPV 31% and NPV 30% with on statistical significance. Conclusions: Combination of uterine and umbilical artery Doppler study in early pregnancy is one of the best indicator for prediction of preeclampsia and IUGR. Therefore, Doppler study may be used for the prediction of preeclampsia and IUGR to reduce the maternal and perinatal morbidity and mortality.


2021 ◽  
Vol 18 (4) ◽  
pp. 268-274
Author(s):  
Gokmen Sukgen ◽  
◽  
Omer Kaya ◽  

Introduction. Although there are various reasons for intrauterine growth restriction (IUGR), the main cause is inadequate utero- placental and feto-placental circulation. Aim. To determine the predictive values of fetal middle cerebral artery/descending aorta (MCA/DA) Doppler parameter in the evaluation of perinatal outcomes in pregnancies with IUGR. Material and methods. 15 with IUGR and 35 normal newborn, who were born at the 34th gestational week or over included into the study. Doppler ultrasonography (US) measurements were performed. The ratio of pulsatility index/resistive index (PI/ RI) from MCA, umbilical artery (Umb), DA was determined. Neonatal characteristics such as Apgar scores, neonatal intensive care unit (NICU) requirement, weight and sex were also recorded. Results. In the IUGR group, mean MCA/DA RI-PI, MCA/UmB RI-PI were 0.88±0.19, 0.86±0.28, 1.22±0.18 and 1.55±0.39, respectively. In the control group, mean MCA/DA RI-PI, MCA/UmB RI-PI were 1.15±0.13, 1.09±0.41, 1.37±0.35 and 1.82±0.44, respectively. There were statistically significant relationship between MCA/DA PI with cord blood pH value and NICU requirement, age with gravida, parity, MCA/UmB RI, MCA/UmB PI; gravida with age and parity; parity with age, gravida, weight, MCA/DA RI, PI ratios. Conclusion. Intrauterine MCA and DA Doppler US parameters of IUGR can be used safely in predicting perinatal outcomes in pregnancies with IUGR over 34 weeks.


2008 ◽  
Vol 88 (1) ◽  
pp. 107-112 ◽  
Author(s):  
Feng Gao ◽  
Xianzhi Hou ◽  
Yingchun Liu

This study investigated the effect of intrauterine growth restriction (IUGR) during late pregnancy on weight and cellularity of the gastrointestinal tract (GIT) in postnatal lambs. Twenty-three Mongolian lambs were entered into the study. Their dams were mated at a synchronized estrus and divided into three groups offered 0.175 MJ ME kg-0.75 d-1 (Restricted Group 1, RG1), 0.33 MJ ME kg-0.75 d-1 (Restricted Group 2, RG2) and Control Group (CG, ad libitum access to feed) during their late pregnancy (90 d), respectively. The lambs were slaughtered at birth (neonatal lambs) and at 28 wk of age. The neonatal abomasum weight, jejunum weight and length, abomasum and jejunum DNA content, and the reticulum protein:DNA ratio were lower for RG1 than those of CG (P < 0.05). At 28 wk of age, there were no significant difference in the weights and lengths of jejunum and the weight of abomasum in the lambs among RG1, RG2 and CG (P > 0.05). However, the rumen and omasum weight, and omasum DNA content were lower for RG1 than for CG (P < 0.05). For the jejunum, the protein:DNA ratios in RG2 were significantly higher than those of CG (P < 0.05). These changes in the weight and cellularity of the GIT may have significant implications on postnatal growth and health. Key words: Intrauterine growth restriction, postnatal lambs, gastrointestinal tract, weight, cellularity


2016 ◽  
Vol 35 (3) ◽  
pp. 511-517 ◽  
Author(s):  
Atalay Ekin ◽  
Cenk Gezer ◽  
Cuneyt Eftal Taner ◽  
Ulas Solmaz ◽  
Naciye Sinem Gezer ◽  
...  

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